Relevant across cultures
Catherine Tay, Leslie Tay. Medico-legal and ethical issues in cardiology and general medicine. Singapore: McGraw-Hill Education (Asia); 2010 pp 200 US$12.50 ISBN-13: 978-0-07-131290-5.
With the increasing complexity in medical care and in the doctor-patient relationship, it is important to keep in mind ethical issues in medical practice and their medico-legal implications. In this book, Prof Tay and Dr Leslie Tay deal with a variety of medical scenarios that are easily identifiable for medical professionals. Succinct and relevant take home messages are given at the end of each scenario. Many of the scenarios are very common, others are somewhat rare. Yet each one carries the reader forward towards a better appreciation of the subject. Problems can arise because of poor communication, lack of knowledge of cultural and other aspects, inability to convince patients about a modality of therapy, etc. The book deals with several cases where these aspects play a role. The case on the inability to afford medical care (Scenario 17) describes what most Indian doctors have to deal with in our hospitals, particularly when serving people from poor socio-economic backgrounds. Likewise, the case on human organ transplantation (Scenario 44) brings home what every transplant team has to deal with in an ethical manner. Another issue relates to withdrawal of life support systems in the ICU setting (Scenario 20) which we face frequently in our hospitals. Financial, ethical, emotional and religious considerations often play a role in the decision making, which is never easy. The appendix is a useful addition and highlights many points which a clinician may not have grasped with clarity. The elaboration of the cardiac cases will be of particular interest to practising cardiologists, but some scenarios are of general clinical interest too. While cultural and other issues may somewhat colour the cases one has to deal with, there can be no doubt that the essential matrix is lucid. This book should find a place in every medical college library as well as major medical institutions, with an emphasis on multispecialty medical centres. Practising lawyers with a special interest in medico-legal issues would also be benefitted. The book is based broadly on Singapore laws, but one sees that there are certain fundamental principles governing medical care which are common across cultures.